Provider Demographics
NPI:1023188257
Name:SENKOWSKI, GINA (MPT)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:SENKOWSKI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:TARONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2222
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:21806 103RD AVENUE CT E
Practice Address - Street 2:STE 103
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-8115
Practice Address - Country:US
Practice Address - Phone:253-847-3700
Practice Address - Fax:425-378-8168
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2015-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00009614225100000X
DEJ1-0002362225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA193035OtherDEPT OF LABOR & INDUSTRY
WA8414096Medicaid
DE1023188257Medicaid
WA8939817OtherCRIME VICTIMS
WAP00288108OtherRAILROAD MEDICARE
P00692898OtherRAILROAD MEDICARE
DE141191ZB82OtherMEDICARE
DEP00692898OtherRAILROAD MEDICARE
DE1023188257OtherDPCI
WA1522SEOtherREGENCE BLUE SHIELD
DE3739248000OtherIBC
WA8852023Medicare ID - Type Unspecified